title: Comparison of anterior subcutaneous and submuscular transposition of ulnar nerve in treatment of cubital tunnel syndrome: A prospective randomized trial.
abstract: BACKGROUND
  This study was designed to compare two methods of surgery, anterior subcutaneous transposition (ASCT) and anterior submuscular transposition (ASMT) of the ulnar nerve in treatment of cubital tunnel syndrome.
  
  
  METHODS
  This randomized trial study was conducted from October 2008 to March 2009 in the Department of Orthopedic Surgery at University Hospital. Forty-eight patients with confirmed cubital tunnel syndrome were randomized in two groups, and each patient received one of two different surgical treatment methods, either ASCT (n = 24) or ASMT (n = 24). In the ASCT technique, the ulnar nerve was transposed and retained in the subcutaneous bed, whereas in the ASMT, the nerve was retained deep in the transected muscular complex, near the median nerve. Patient outcomes, including pain, sensation, muscle strength, and muscle atrophy were compared between groups.
  
  
  RESULTS
  The two groups were similar in baseline characteristics. However, those treated with ASMT had a statistically significant reduction in their pain levels compared with ASCT (21 (87.5%) vs 8 (33.3%), P < 0.05). There were no statistically significant differences between the two groups relative to sensation (11 (45.8%) vs 12 (50%)), muscle strength (17 (70.8%) vs 15 (62.5%)), or muscle atrophy (15 (62.5%) vs 17 (70.8%)) (P > 0.05).
  
  
  CONCLUSIONS
  Our results indicate that ASMT are more efficient than ASCT for managing cubital tunnel syndrome. In patients who had ASMT, there were significant reductions of pain compared with ASCT.
authors.affiliation: Department of Orthopedic, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Abolghassem
authors.initials: A
authors.lastname: Zarezadeh
authors.forename: Hamidreza
authors.initials: H
authors.lastname: Shemshaki
authors.forename: Mohsen
authors.initials: M
authors.lastname: Nourbakhsh
authors.forename: Mohammad R
authors.initials: MR
authors.lastname: Etemadifar
authors.forename: Malihe
authors.initials: M
authors.lastname: Moeini
authors.forename: Farhad
authors.initials: F
authors.lastname: Mazoochian
keywords: Cubital tunnel syndrome; subcutaneous; submuscular; transposition